| NPI | 1457628786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: MA 281137) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 281137) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA10323000) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2021-06-07 |